Kolkhir P, Pogorelov D, Olisova O, Maurer M
Department of Dermatology and Venereology, Sechenov First Moscow State Medical University, Moscow, Russia.
Department of Dermatology and Allergy, Charité-Universitätsmedizin Berlin, Berlin, Germany.
Clin Exp Allergy. 2016 Feb;46(2):275-87. doi: 10.1111/cea.12673.
Chronic spontaneous urticaria (CSU) is a common mast cell-driven disease characterized by the development of wheals (hives), angioedema (AE), or both for > 6 weeks. It is thought that autoimmunity is a common cause of CSU, which is often associated with autoimmune thyroiditis, whereas the link to other autoimmune disorders such as systemic lupus erythematosus (SLE) has not been carefully explored. Here, we systematically reviewed the existing literature for information on the prevalence of CSU in SLE (and vice versa) and we examined the possible clinical and pathogenetic relationship between CSU and SLE. The prevalence of CSU and CSU-like rash in SLE was investigated by 42 independent studies and comorbidity in adult patients reportedly ranged from 0% to 21.9% and 0.4% to 27.5%, respectively (urticarial vasculitis: 0-20%). In children with SLE, CSU was reported in 0-1.2% and CSU-like rash in 4.5-12% (urticarial vasculitis: 0-2.2%). In contrast, little information is available on the prevalence of SLE in patients with CSU, and more studies are needed to determine the rate of comorbidity. Recent insights on IgG- and IgE-mediated autoreactivity suggest similarities in the pathogenesis of CSU and SLE linking inflammation and autoimmunity with the activation of the complement and coagulation system. Future studies of patients with either or both conditions could help to better define common pathomechanisms in CSU and SLE and to develop novel targeted treatment options for patients with CSU and SLE.
慢性自发性荨麻疹（CSU）是一种常见的肥大细胞驱动性疾病，其特征为风团（荨麻疹）、血管性水肿（AE）或两者同时出现超过6周。人们认为自身免疫是CSU的常见病因，CSU常与自身免疫性甲状腺炎相关，而与系统性红斑狼疮（SLE）等其他自身免疫性疾病的关联尚未得到仔细研究。在此，我们系统回顾了现有文献，以获取关于SLE中CSU患病率的信息（反之亦然），并研究了CSU与SLE之间可能的临床和发病机制关系。42项独立研究调查了SLE中CSU和CSU样皮疹的患病率，据报道成年患者的合并症发生率分别为0%至21.9%和0.4%至27.5%（荨麻疹性血管炎：0 - 20%）。在儿童SLE患者中，CSU的报告发生率为0 - 1.2%，CSU样皮疹为4.5 - 12%（荨麻疹性血管炎：0 - 2.2%）。相比之下，关于CSU患者中SLE患病率的信息较少，需要更多研究来确定合并症发生率。最近对IgG和IgE介导的自身反应性的见解表明，CSU和SLE的发病机制存在相似之处，将炎症和自身免疫与补体和凝血系统的激活联系起来。对患有其中一种或两种疾病的患者进行进一步研究，可能有助于更好地确定CSU和SLE的共同发病机制，并为CSU和SLE患者开发新的靶向治疗方案。
